Medical billing company” may sound like a pretty simple business, but there are a lot of related services that may be (and usually are) offered. Many, including Medcare MSO, offer a full suite of medical revenue cycle management (RCM) services, covering everything from medical transcription services to credentialing and more.
1. A Medical Billing Company Can (and Should) Follow Up On Denied Claims
A good medical billing company can greatly reduce the number of rejected and denied claims you receive; however, there will be some denials no matter how carefully claims are prepared. It is essential that denied claims be tracked and appealed.
The insurer must have a specific reason for denying a claim, but understanding the notation that supposedly explains it is not easy. Companies offering denial management services are familiar with the common reasons and the unusual issues that arise, so are able to efficiently appeal.
Billions in earned revenue will be lost every year if denied claims are not processed, but having inexperienced billers try to manage them can result in labor costs that exceed claim values, so follow-up by a professional medical billing company gets the best results.
2. Payment Depends on Eligibility and Benefits Verification
An important part of accepting any patient is verifying their insurance or government program coverage. These programs and plans can be extremely detailed in specifying what is included and excluded. Medical offices have always included staff to deal with this, but it is easily delegated to an external medical billing company.
A convenient feature of all the top EMR systems in 2022 is that they provide secure transmission of patient data, allowing all of these functions to be managed offsite as quickly as they could be in the office. Since staff in a medical office have many other duties to attend to throughout the day, these types of administrative tasks get done more efficiently remotely.
3. Managing Old AR Is a Necessary Service
Handling accounts receivable is another important service that a billing company can provide. Patients will not pay a bill they do not understand, so having billers available to interpret their bills and explain what the charges are, how much was paid and why they are responsible for the remaining amount makes a big difference in the amount of revenue received.
Collection services are also something that a good billing company can provide. Medical bills are frustrating and can even be overwhelming for many patients, but providers still need to be paid. It is important for the collection services to be handled in a way that works with patients to get bills paid off, without being threatening. Having collections done by medical billing staff who can interpret the bills have proven to be effective.
4. KPI Reports Keep Providers Informed
Medical billing companies keep track of a variety of key performance indicators (KPIs) to assess the effectiveness of their operations as well as to keep you informed about your revenue cycle. If the idea of putting someone else in a position with so much control over your finances is unnerving, look at it from another perspective. At the end of the business day, instead of trying to figure out your cash flow and accounts, you could sit down and review a report that has already compiled all the most important metrics.
You can use these reports to confirm where simple things like total revenue are at, but KPI reports also let you see if the number of denials is going down and if bills are being paid more quickly, both of which indicate how well the medical billing process is working.
As the need to be in-network grows, it is becoming more important to have an efficient process for getting accepted by insurers. For a qualified medical practice, credentialing is just a matter of paperwork, but no one who is running a business has time for more of that. An experienced credentialing team is familiar with the process and can make sure everything gets turned in and you are not held off from being able to serve patients just because the right forms were not submitted.
Medcare MSO has over a decade of experience in medical billing and is committed to standing out for our customer service. We listen to the needs of our clients and as a result, have expanded our offering to include all aspects of RCM. That’s in addition to our growing staff of billers using our proven process for tracking and managing claims, so no earned revenue is lost. Would you like to find out if we can help make your business more profitable and enjoyable to run? Call today and we’d love to discuss how we could work together. We’re easy to reach at 800-640-6409.